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Clinical outcomes of bortezomib-based therapy in Taiwanese patients with multiple myeloma: A nationwide population-based study and a single-institute analysis


Autoři: Wei-Nung Liu aff001;  Chao-Feng Chang aff002;  Chi-Hsiang Chung aff003;  Wu-Chien Chien aff003;  Tzu-Chuan Huang aff001;  Yi-Ying Wu aff001;  Ching-Liang Ho aff001;  Jia-Hong Chen aff001
Působiště autorů: Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aff001;  Division of Gastroenterology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aff002;  School of Public Health, National Defense Medical Center, Taipei, Taiwan aff003;  Taiwanese Injury Prevention and Safety Promotion Association, National Defense Medical Center, Taipei, Taiwan aff004;  Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aff005;  Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222522

Souhrn

Purpose

In a retrospective cohort study, we report the current epidemiology of patients with multiple myeloma (MM) and analyze the real-world clinical outcomes of bortezomib-based therapy.

Materials and methods

This retrospective study was mainly designed to evaluate the characteristics, treatment outcomes, and prognostic factors of patients with MM who received bortezomib-based therapy. We identified 5,726 patients in Taiwan with MM newly diagnosed between 2007 and 2015. Confidential data from the National Health Insurance Research Database (NHIRD) was used under strict guidelines, as it was made available in an electronic format for research purposes. In addition, we analyzed 96 patients who have been diagnosed with MM and were treated at the Tri-Service General Hospital (TSGH) between January 1, 2002, and December 31, 2018.

Results

Patients receiving first-line treatment with bortezomib had longer overall survival (OS) compared to those who received non-first-line treatment (p<0.001). In addition, the statistically lowest risk of mortality was when patients received first-line bortezomib followed by an autologous hematopoietic stem cell transplant (adjusted hazard ratio = 0.39, p<0.001). In the TSGH study, the patients were enrolled between January 1, 2002, and December 31, 2018, with an initial diagnosis of MM; there were 96 individuals treated with bortezomib. There was no statistically significant difference in the OS or progression-free survival (PFS) according to the gender, myeloma type, International Staging System stage, or treatment regimen. There was a significant difference in the PFS in patients receiving first-line bortezomib treatment with transplantation compared to those without transplantation (p = 0.021).

Conclusions

Bortezomib as a first-line treatment extended the OS in four-year mortality tracking and lowered the mortality risk according to the NHIRD analysis. In the TSGH analysis, the results indicated that the initial conditions of patients with MM have a lower influence on the OS and PFS after bortezomib-based therapy was administered.

Klíčová slova:

Medicine and health sciences – Oncology – Cancers and neoplasms – Hematologic cancers and related disorders – Myelomas and lymphoproliferative diseases – Myelomas – Hematology – Plasma cell disorders – Health care – Health economics – Pulmonology – Chronic obstructive pulmonary disease – Vascular medicine – Coronary heart disease – Cardiology – Surgical and invasive medical procedures – Blood and lymphatic system procedures – Bone marrow transplantation – Transplantation – People and places – Geographical locations – Asia – Taiwan – Research and analysis methods – Research design – Cohort studies – Social sciences – Economics – Health insurance


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